慢性肾脏疾病患者的免疫检查点抑制剂:评估其引起急性肾损伤的能力并告知其正确使用

IF 3 3区 医学 Q2 ONCOLOGY
Ji Won Min , Jeong Uk Lim
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引用次数: 0

摘要

免疫检查点抑制剂(ICI)已获得世界各地监管机构的批准,用于治疗各种类型的癌症。尽管不像涉及其他器官的免疫相关不良事件(AE)那样频繁,但也有相当数量的ici相关肾脏AE被报道,预测此类事件变得非常重要。我们对ici相关急性肾损伤(AKI)的可能机制、相关危险因素以及ici在慢性肾脏疾病(CKD)患者中的应用进行了最新综述。对相关文章进行了系统的检索。急性肾小管间质性肾炎(ATIN)是ici相关性AKI的主要原因,肾小球肾炎也是一个重要原因。包括同时使用药物、肾外免疫相关不良反应和两种或两种以上免疫治疗药物联合使用在内的因素都是可能的危险因素。慢性肾病患者使用ICI可能与总体免疫相关不良事件的发生率增加有关。如果确诊ICI相关的肾脏不良事件,建议及时使用类固醇,在AKI的严重病例中,应考虑停用ICI。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Immune checkpoint inhibitors in patients with chronic kidney disease: Assessing their ability to cause acute kidney injury and informing their proper use

Immune check point inhibitors (ICI) have secured regulatory approvals across the world for the treatment of various types of cancers. Though not as frequent as immune-related adverse events (AEs) involving other organs, a considerable number of ICI-related renal AE have also been reported and predicting such events has become important. We provide an updated review on possible mechanisms of ICI-related acute kidney injury (AKI), related risk factors, and the use of ICIs in patients with chronic kidney diseases (CKD). A systematic search for related articles was conducted. Acute tubulointerstitial nephritis (ATIN) is known to be the main cause of ICI-related AKI, with glomerulonephritis also a significant cause. Factors including use of concurrent medications, extra-renal immune related AEs, and combination of two or more immunotherapy drugs are possible risk factors. Use of ICI in patients with CKD may be related to increased occurrence of overall immune related AEs. If the diagnosis of ICI related renal AEs is confirmed, prompt use of steroids is recommended, and in severe cases of AKI, discontinuation of ICI should be considered.

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来源期刊
Seminars in oncology
Seminars in oncology 医学-肿瘤学
CiteScore
6.60
自引率
0.00%
发文量
58
审稿时长
104 days
期刊介绍: Seminars in Oncology brings you current, authoritative, and practical reviews of developments in the etiology, diagnosis and management of cancer. Each issue examines topics of clinical importance, with an emphasis on providing both the basic knowledge needed to better understand a topic as well as evidence-based opinions from leaders in the field. Seminars in Oncology also seeks to be a venue for sharing a diversity of opinions including those that might be considered "outside the box". We welcome a healthy and respectful exchange of opinions and urge you to approach us with your insights as well as suggestions of topics that you deem worthy of coverage. By helping the reader understand the basic biology and the therapy of cancer as they learn the nuances from experts, all in a journal that encourages the exchange of ideas we aim to help move the treatment of cancer forward.
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